Age-dependent adaptations to anticipated and non-anticipated perturbations after balance training in children

Comparing body posture and postural control in children with intellectual disability and dyslexia to typically developing children using technology‑based assessments

Background/Aims

Children with intellectual disability and dyslexia have poor academic and behavioural skills related to social participation, as well as poor motor skills compared to typically developing children. Most training programmes for these children focus on the academic and behavioural aspects of special education, overlooking musculoskeletal and motor development needs. The aim of this study was to investigate body posture and postural control in children with intellectual disability and dyslexia compared to typically developing children using technology-based assessments.

Methods

A total of 77 children (36 with dyslexia, 21 with intellectual disability and 20 typically developing children) took part in the study. The PostureScreen Mobile app was used to evaluate body posture and the Fizyosoft Balance System was used to assess postural control.

Results

Significant postural differences were observed in children with intellectual disability when compared to typically developing children. Head, shoulder and knee translations in the sagittal plane were significantly higher in children with intellectual disability than typically developing children. Centre of pressure velocities were significantly higher in children with dyslexia. Centre of pressure displacements showed non-significant differences in the children with dyslexia compared to the children with intellectual disability and typically developing children.

Conclusions

The present study found that children with dyslexia had poor postural control and children with intellectual disability had poor quality of posture compared to typically developing children. The authors believe that motor and physical assessments with objective outcome measurements should be conducted for children with dyslexia and intellectual disability to help improve their motor development.

No sex-specific effects of balance training on dynamic balance performance in healthy children

Background

Cross-sectional studies in children reported better balance performance for girls than for boys. Thus, balance trainability might be different between female and male children. The aim of the present study was to examine the effects of balance training (BT) on dynamic balance performance in girls compared to boys.

Methods

Seventeen girls (age: 11.1 ± 0.7 years) and 22 boys (age: 11.1 ± 0.8 years) were assigned to either a BT-group or an active control (CON) group. BT was conducted over eight weeks (two sessions/week) while the CON-groups received their regular physical education lessons during the same period. Before and after treatment, dynamic balance performance was assessed by using the Lower Quarter Y-Balance (YBT-LQ) test. A series of three-way analyses of covariance (ANCOVA) were undertaken to test for within-between effects of Test [×2 (pretest vs. posttest)], Group [×2 (BT-group vs. CON-group)] and Sex [×2 (boys vs. girls)].

Results

The three-way ANCOVA yielded a significant main effect of Test (p = 0.002-0.043, η p 2 = 0.122-0.262) and of Group (all p < 0.001, η p 2 = 0.330-0.651) but not of sex for all YBT-LQ reach directions and the composite score. Further, there were significant Test × Group interactions (all p < 0.001, η p 2 = 0.330-0.651) in favor of both BT-groups but neither Test × Sex nor Test × Group × Sex interactions were detected.

Conclusions

We conclude that BT is an effective treatment to improve dynamic balance performance in healthy children regardless of their sex. Consequently, girls and boys can be provided with the same BT regime to enhance their postural control.

Effects of Different Balance Training Volumes on Children's Dynamic Balance

Concerning balance training, the most effective design of several load dimensions (e. g., training frequency, volume) is unclear. Thus, we determined the effects of different balance training volumes on dynamic balance in healthy children. Three groups of 20 children (age: 11.0±0.7 years; 47% females) were randomly assigned to a balance training group using a low or a high training volume or an active control group that performed regular physical education lessons. All groups trained for 8 weeks (2 sessions/week), whereby balance training volume amounted to 4 min/session and 18-24 min/session for the low- and high-volume group, respectively. Pre- and post-training, balance performance was assessed using the Lower Quarter Y-Balance Test and the Timed-Up-and-Go Test. Fifty-five children completed the study and significant Test x Group interactions were detected for both outcome measures in favor of the two balance training groups. Additionally, improvements in the high-volume group were significantly larger for some measures (Y-balance test anterior reach distance: p <.001, d =.94; Timed-Up-and-Go time: p =.003, d =.81) compared to the low-volume group. The results indicate that balance training is effective to improve balance performance in healthy children and it seems that a 36-48 min/week compared to an 8 min/week training volume provides additional effects.

Effects of Balance Training on Balance Performance in Youth: Are There Age Differences?

Purpose: In youth, cross-sectional studies reported age differences in balance performance that were in favor of adolescents. Thus, trainability of balance performance might be different in children compared to adolescents. The purpose of this study was therefore to compare the effects of balance training (BT) on balance performance between children and adolescents.Method: Thirty children (7.5 ± 0.5 years) and 42 adolescents (14.7 ± 0.5 years) participated in this study and were assigned to either a BT-group or a control (CON) group. In both age groups, BT was conducted over five weeks while the CON-groups received their regular physical education lessons. Pre- and posttests included the assessment of mobility, static steady-state, proactive, and reactive balance.Results: Significant Test × Group × Age interactions were found for static steady-state balance (i.e., CoP displacements during single leg stance) and mobility (i.e., 10-m gait velocity). For both measures, post hoc analysis revealed larger improvements (+16-37%, 0.001 ≤ p ≤ 0.033, 0.65 ≤ d ≤ 2.24) for children compared to adolescents. For proxies of proactive and reactive balance, we could not detect significant Test × Group × Age interactions.Conclusions: We conclude that trainability of static steady-state balance and mobility seems to be higher in children than in adolescents indicating larger adaptive reserves in children compared to adolescents. However, there were no age differences in adaptations to BT with respect to proactive and reactive balance.

The cross-sectional relationships between age, standing static balance, and standing dynamic balance reactions in typically developing children

BACKGROUND

Static balance performance is a common metric for evaluating the development of postural control in children. Less is known about the potentially independent development of dynamic balance performance.

RESEARCH QUESTION

How does age relate to static (i.e. postural sway) and dynamic (i.e. stepping thresholds) standing balance performance, and what is the relationship between postural sway and stepping thresholds?

METHODS

Twenty-six typically developing children (12 males, 14 females; 5-12 years of age) were recruited for this cross-sectional study. Static balance performance was quantified as the total path length during a postural sway assessment using a force platform with conditions of eyes open and eyes closed. Dynamic balance performance was quantified using a single-stepping threshold assessment, whereby participants attempted to prevent a step in response to treadmill-induced perturbations in the anterior and posterior directions. Relationships between age and body-size scaled measures of static and dynamic balance performance were assessed using Spearman rank correlations.

RESULTS

There was a weak correlation between age and postural sway (|r_s| < 0.10, p >  0.68), but a moderate-to-strong correlation between age and single-stepping thresholds (r_s > 0.68, p < 0.001). A weak correlation was found between postural sway and single-stepping thresholds (|r_s| < 0.20, p >  0.39).

SIGNIFICANCE

Dynamic, but not static standing balance performance, may improve with typical development between the ages of 5 and 12 years. Static and dynamic balance should be considered as unique constructs when assessed in children.

Age and sex differences in human balance performance from 6-18 years of age: A systematic review and meta-analysis

Background

The process of growing leads to inter-individual differences in the timing of growth, maturational, and developmental processes during childhood and adolescence, also affecting balance performance in youth. However, differences in balance performance by age and sex in youth have not been systematically investigated yet.

Objective

The objective of the present study was to characterize and quantify age- and sex-related differences in balance performance in healthy youth.

Methods

A computerized systematic literature search was performed in the electronic databases PubMed, Web of Science, and SPORTDiscus. To be applicable for analysis, studies had to report at least one measure of static steady-state, dynamic steady-state, proactive or reactive balance in healthy children (6–12 years) and/or adolescents (13–18 years). Coding of the studies was done according to the following criteria: age, sex, and balance outcome. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies. Weighted standardized mean differences were calculated and classified according to their magnitude.

Results

Twenty-one studies examined age-related differences in balance performance. A large effect for measures of static steady-state balance (SMD_ba = 1.20) and small effects for proxies of dynamic steady-state (SMD_ba = 0.26) and proactive balance (SMD_ba = 0.28) were found; all in favor of adolescents. Twenty-five studies investigated sex-related differences in balance performance. A small-sized effect was observed for static steady-state balance (SMD_bs = 0.33) in favor of girls and for dynamic steady-state (SMD_bs -0.02) and proactive balance (SMD_bs = -0.15) in favor of boys. Due to a lack of studies, no analysis for measures of reactive balance was performed.

Conclusions

Our systematic review and meta-analysis revealed better balance performances in adolescents compared to children, irrespective of the measure considered. Sex-related differences were inconsistent. These findings may have implications for example in terms of trainability of balance in youth that should be investigated in future studies.